COVID-19 symptom severity
We calculated the distribution of COVID-19 symptom severity across
groups in six categories: 0/“asymptomatic,” 1/“mild,”
2/“moderate,” 3/“severe,” 4/“very severe,” and 5/“fatal” (Table
1B). Our initial analysis focused on the entire cohort of patients,
agnostic to laboratory evidence of COVID-19 infection. Treatment groups
were compared to determine the proportions of patients in each symptom
category (Figure 1). Given the potential for multiple confounders and
risk factors for symptomatic infection (Table 1A),32we adjusted for known risk factors for increased COVID-19 morbidity
(e.g., obesity, hypertension, etc.) using logistic regression models. We
found that patients on dupilumab were less likely to experience
moderate-to-severe symptoms compared to patients on other systemic
treatments (OR=3.89; p=0.008, Table 2A). Furthermore, they were less
likely to experience moderate-to-severe symptoms compared to those on
limited/no treatments (OR=1.96; p=0.04; Table 2B). Additionally, BMI was
significantly associated with moderate-to-severe symptoms across
COVID-19 related patients treated with biologic and systemic therapies
(p<0.001, Table 2A).
When evaluating the effects of various clinical variables on the
presence of COVID-19-related symptoms, we found that non-biologic
systemic treatment was significantly associated with symptomatology
relative to treatment with dupilumab (OR=1.87; p=0.01, Table 2C).
However, there were no differences in predicting symptomatology among
patients on dupilumab relative to the limited/no treatment group (Table
2D).